Delayed bedtime on non-school days associates with higher weight and waist circumference in children: Cross-sectional and longitudinal analyses with Mendelian randomisation

Sleep duration has been linked with obesity in population-based studies. Less is known about bedtimes and, especially, if discrepancy between bedtimes on school and non-school days associate with adiposity in children. The associations of self-reported bedtimes with the body mass index z-score (BMIz) and waist-to-height ratio (WtHr) were examined among children with a mean (SD) age of 11.2 (0.85) years in cross-sectional (n = 10,245) and longitudinal (n = 5085) study settings. The causal relationship of whether BMIz contributes to bedtimes, was further examined in a subset of 1064 participants by exploiting Mendelian randomisation (MR). After adjusting for sleep duration and other confounders, every 0.5 h later bedtime on non-school nights and a delay in bedtime in non-school nights compared with school nights associated with 0.048 (95% CI 0.027; 0.069) and 0.08 (95% CI 0.056; 0.105) higher BMIz as well as 0.001 (95% CI 0; 0.002) and 0.004 (95% CI 0.003; 0.005) with higher WtHr, respectively. Moreover, every 0.5-h delay in bedtime in non-school nights compared with school nights associated with 0.001 (95% CI 0; 0.002) greater increase in WtHr in the 2.5 years follow-up. Thus, a 2-h delay in bedtime at the age of 11 years corresponds with a 0.6 cm increase in waist circumference. The MR analysis did not indicate an opposite causal relationship: higher BMIz was not causing delayed bedtimes. Later bedtime on non-school days and discrepancy in bedtimes associated with increased BMIz and WtHr, while longitudinally these predicted higher WtHr, independently of sleep duration. Promoting early bedtimes, especially on weekends, should be considered in obesity prevention among school-aged children.

Genetic risk of type 2 diabetes modifies the association between lifestyle and glycemic health at 5 years postpartum among high-risk women

INTRODUCTION

Lifestyle interventions are effective in preventing type 2 diabetes, but genetic background may influence the individual response. In the Finnish gestational diabetes prevention study, RADIEL, lifestyle intervention during pregnancy and first postpartum year was effective in preventing gestational diabetes (GDM) and postpartum glycemic abnormalities only among women at highest genetic risk of type 2 diabetes. This study aimed to assess whether still 5 years postpartum the genetic risk modifies the association between lifestyle and glycemic health.

RESEARCH DESIGN AND METHODS

The RADIEL study (randomized controlled trial) aimed to prevent GDM with a lifestyle intervention among high-risk women (body mass index ≥30 kg/m2 and/or prior GDM). The follow-up study 5 years postpartum included anthropometric measurements, laboratory assessments, device-measured physical activity (PA), and questionnaires. A Healthy Lifestyle Score (HLS) indicated adherence to lifestyle goals (PA, diet, smoking) and a polygenic risk score (PRS) based on 50 type 2 diabetes risk alleles depicted the genetic risk.

RESULTS

Altogether 314 women provided genetic and glycemic data 5 years postpartum. The PRS for type 2 diabetes was not associated with glycemic abnormalities, nor was HLS in the total study sample. There was, however, an interaction between HLS and type 2 diabetes PRS on glycemic abnormalities (p=0.03). When assessing the association between HLS and glycemic abnormalities in PRS tertiles, HLS was associated with reduced risk of glycemic abnormalities only among women at the highest genetic risk (p=0.008).

CONCLUSIONS

These results extend our previous findings from pregnancy and first postpartum year demonstrating that still at 5 years postpartum, healthy lifestyle is associated with a lower risk of prediabetes/diabetes only among women at the highest genetic risk of type 2 diabetes.

How energy balance-related behaviours, temperament, stress and overweight associate: a cross-sectional study of Finnish preschoolers

OBJECTIVE

This study aimed to (1) examine the clustering of energy balance-related behaviours (EBRB) and (2) investigate whether EBRB clusters, temperament and hair cortisol concentration (HCC) associate with overweight.

DESIGN

We assessed food consumption using food records, screen time (ST) using sedentary behaviour diaries, sleep consistency and temperament (negative affectivity, surgency, effortful control) using questionnaires and HCC using hair samples. Accelerometers were used to assess physical activity (PA) intensities, sleep duration and sleep efficiency. Researchers measured each child's weight and height. We used finite mixture models to identify EBRB clusters and multilevel logistic regression models to examine the associations between EBRB clusters, temperament, HCC and overweight.

SETTING

The cross-sectional DAGIS survey, data collected in 2015-2016.

PARTICIPANTS

Finnish 3-6-year-olds (n 864) recruited through preschools.

RESULTS

One-third of the participants were categorised into the cluster labelled 'Unhealthy diet, excessive screen time', characterised by unhealthy dietary choices (e.g. greater consumption of high-fat, high-sugar dairy products) and longer ST. Two-thirds were categorised into the second cluster, labelled 'Healthy diet, moderate screen time'. PA and sleep were irrelevant for clustering. Higher negative affectivity and lower effortful control associated with the 'Unhealthy diet, excessive screen time' cluster. EBRB clusters and HCC did not associate with overweight, but surgency was positively associated with overweight (OR = 1·63, 95 % CI 1·17, 2·25).

CONCLUSIONS

Of the EBRB, food consumption and ST seem to associate. As temperament associates with EBRB clusters and overweight, tailored support acknowledging the child's temperament could be profitable in maintaining a healthy weight.

Antibiotic exposures and the development of pediatric autoimmune diseases: a register-based case-control study

BACKGROUND

Antibiotics have been associated with several individual autoimmune diseases (ADs). This study aims to discover whether pre-diagnostic antibiotics are associated with the onset of ADs in general.

METHODS

From a cohort of 11,407 children, 242 developed ADs (type 1 diabetes, autoimmune thyroiditis, juvenile idiopathic arthritis (JIA), or inflammatory bowel diseases) by a median age of 16 years. Antibiotic purchases from birth until the date of diagnosis (or respective date in the matched controls n = 708) were traced from national registers.

RESULTS

Total number of antibiotic purchases was not related to the onset of ADs when studied as a group. Of specific diagnoses, JIA was associated with the total number of antibiotics throughout the childhood and with broad-spectrum antibiotics before the age of 3 years. Intriguingly, recent and frequent antibiotic use (within 2 years before diagnosis and ≥3 purchases) was associated with the onset of ADs (OR 1.72, 95% CI 1.08-2.74). Regardless of frequent use in childhood (40% of all antibiotics), penicillin group antibiotics were not related to any ADs.

CONCLUSIONS

Use of antibiotics was relatively safe regarding the overall development of ADs. However, broad-spectrum antibiotics should be used considerately as they may associate with an increased likelihood of JIA.

IMPACT

Increasing numbers of antibiotic purchases before the age of 3 years or throughout childhood were not associated with the development of pediatric autoimmune diseases. Broad-spectrum antibiotics were related to the development of autoimmune diseases, especially juvenile idiopathic arthritis in children, while penicillin group antibiotics were not. The use of broad-spectrum antibiotics in children should be cautious as they may carry along a risk for autoimmune disease development.

Parent-child nature visits and young Finnish childreńs nature connectedness

Background

It is well-known that frequent nature visits are associated with health benefits in children. Global climate crisis and environmental challenges emphasize the need for reconnecting children to nature, as well. Young children’s nature connectedness (NC) involves enjoyment of nature, sense of responsibility, empathy, and awareness of nature. The study examines whether there is an association between the frequency of parent-child nature visits and young children’s NC.

Methods

The study uses WEB survey data from the Finnish Empowered by Nature project. Respondents, n = 1463, were parents of children aged 2 to 7 years old. NC was assessed by 11-items derived from the NC questionnaire of Sobko et al (2018). Multinomial logistic regression analysis was used and the lowest tertile of NC was used as reference group. Analysis were adjusted for child’s age and gender, and highest education of parent.

Results

Children with moderate (1-2 times a week in previous month) or high (3 times a week or more) frequency of parent-child nature visits were more likely to have strong than weak NC compared to children with low frequency (less than once a week) of adult-child nature visits. Odds ratios (OR) in adjusted models were: moderate frequency 1.67 (1.21- 2.32), and high frequency 2.31 (1.67-3.18). The odds of having medium NC compared to weak NC were more likely in moderate frequency compared to low frequency of parent-child nature visits in the adjusted model (OR 1.46; 1.07-2.00).

Conclusions

The results highlight the importance of parents visiting nature frequently with their children during early childhood. It promotes young children’s NC and may further contribute to raising environmentally responsible children.

Key messages

• More frequent parent-child visits promote young children’s nature connectedness which involves enjoyment of nature, sense of responsibility, empathy, and awareness of nature.

• A strong nature connectedness among children is highly relevant, as it may contribute to raise environmentally responsible children.

Comparing estimates of physical activity in children across different cut-points and the associations with weight status

This study aimed to compare sedentary time (SED) and intensity-specific physical activity (PA) estimates and the associations of SED and PA with body mass index (BMI) and waist circumference (WC) using three different sets of cut-points in preschool-aged children. A total of 751 children (4.7 ± 0.9 years, boys 52.7%) wore an ActiGraph GT3X+BT accelerometer on their hip for 7 days (24 h). Euclidean norm -1 G with negative values rounded to zero (ENMO) and activity counts from vertical axis (VACounts) and vector magnitude (VMCounts) were derived. Estimates of SED and light, moderate, vigorous, and moderate-to-vigorous PA (MVPA) were calculated for commonly used cut-points by Hildebrand et al., Butte et al., and Evenson et al. Furthermore, the prevalence of meeting the PA recommendation, 180 min/day of which at least 60 min/day being MVPA, were assessed for the cut-points. Multilevel mixed analysis was used to examine associations of SED and PA with BMI and WC. In accordance with the results, SED and PA intensity estimates differed largely across cut-points (i.e., SED = 22-341 min/day; light PA = 52-257 min/day; moderate PA = 5-18 min/day; vigorous PA = 7-17 min/day; MVPA = 13-35 min/day), and the prevalence of children meeting the PA recommendation varied from 4% to 70%. Associations of SED and PA with BMI or WC varied between the cut-points. Our results indicate that SED and PA estimates in preschool-aged children between studies using these cut-points are poorly comparable. Methods facilitating accelerometer-derived PA estimate comparison between studies are highly warranted.

The Composition and Functional Capacities of Saliva Microbiota Differ Between Children With Low and High Sweet Treat Consumption

Excess sugar consumption—common in youth—is associated with poor health. Evidence on the relationship between sugar consumption and the oral microbiome, however, remains scarce and inconclusive. We explored whether the diversity, composition, and functional capacities of saliva microbiota differ based on the consumption of select sugary foods and drinks (“sweet treats”). Using 16S rRNA gene sequencing, we characterized saliva microbiota from 11 to 13-year-old children who participated in the Finnish Health in Teens (Fin-HIT) cohort study. The sample comprised children in the lowest (n = 227) and highest (n = 226) tertiles of sweet treat consumption. We compared differences in the alpha diversity (Shannon, inverse Simpson, and Chao1 indices), beta diversity (principal coordinates analysis based on Bray–Curtis dissimilarity), and abundance (differentially abundant operational taxonomic units (OTUs) at the genus level) between these low and high consumption groups. We performed PICRUSt2 to predict the metabolic pathways of microbial communities. No differences emerged in the alpha diversity between low and high sweet treat consumption, whereas the beta diversity differed between groups (p = 0.001). The abundance of several genera such as Streptococcus, Prevotella, Veillonella, and Selenomonas was higher in the high consumption group compared with the low consumption group following false discovery rate correction (p < 0.05). Children with high sweet treat consumption exhibited higher proportions of nitrate reduction IV and gondoate biosynthesis pathways compared with the low consumption group (p < 0.05). To conclude, sweet treat consumption shapes saliva microbiota. Children who consume a high level of sweet treats exhibited different compositions and metabolic pathways compared with children who consume low levels of sweet treats. Our findings reveal novel insights into the relationship between sugary diets and oral microbiota.

Central obesity in school-aged children increases the likelihood of developing paediatric autoimmune diseases

BACKGROUND

The incidences of both paediatric obesity and autoimmune diseases have been increasing, but their relationship with one another is unclear.

OBJECTIVE

To determine whether obesity or particular dietary patterns in school-aged children are potential risk factors for autoimmune diseases during adolescence.

METHODS

This matched case-control study included 525 children, followed up from a median age of 11.3 to 16.7 years. Of them, 105 children received primary autoimmune diagnoses (diabetes, thyroiditis, arthritis, or inflammatory bowel diseases) after baseline and generated the case group. Four children with matching age, sex, and residential area generated the control group of 420 children. At baseline, age- and sex-specific body mass index categories were acquired and waist-to-height ratio (WHTR) was calculated. Central obesity was present when WHTR ≥0.5. Dietary patterns were analysed using a food frequency questionnaire (FFQ).

RESULTS

School-aged children with central obesity were 2.11 (OR, 95% CI 1.11-3.98) times more likely to develop autoimmune diseases before age of 19 years than those without central obesity. Being overweight was not related to the onset of these diseases (OR 1.60, 95% CI 0.89-2.87, nor were dietary patterns.

CONCLUSION

Central obesity in school-aged children was related to the development of autoimmune diseases, while being overweight and dietary patterns were not.

Prevalence of Thinness, Overweight, Obesity, and Central Obesity in Finnish School-Aged Children: A Comparison of National and International Reference Values

INTRODUCTION

The global epidemic of obesity concerns children, and monitoring the prevalence is of highest priority. Body mass index (BMI) with age- and sex-specific cutoff values determines weight status in children, although multiple reference systems exist. Our aim was to compare the prevalence for thinness, normal weight, overweight, and obesity in Finnish school-aged children according to national and international reference values, as well as to determine which cutoff values for overweight agree with the criteria for central obesity.

METHODS

This study includes 10,646 children aged 9-12 years from the Finnish Health in Teens cohort. Height, weight, and waist circumference were measured in 2011-2014. BMI (weight [kg]/height [m]2) and the waist-to-height ratio (WHtR; waist [cm]/height [cm]) were calculated. The WHtR cutoff of >0.5 indicated central obesity. We compared the sex-specific prevalence of thinness, overweight, and obesity using the International Obesity Task Force (IOTF), World Health Organization (WHO) and Finnish (FIN) BMI-for-age reference values, as well as these three against central obesity based on the WHtR.

RESULTS

The prevalence of thinness, overweight, and obesity were 11.0%, 12.7%, and 2.6%, respectively, using IOTF; 2.6%, 15.9%, and 5.2% using WHO; and 5.1%, 11.4%, and 2.2% using FIN. Overweight and obesity were more common in boys than girls using WHO and FIN, while thinness was more common in girls using IOTF and FIN. IOTF versus WHO exhibited moderate agreement (κ = 0.59), which improved for IOTF versus FIN (κ = 0.74). Of those classified as overweight by WHO, 37% and 47% were regarded as normal weight according to IOTF and FIN, respectively. The prevalence of central obesity was 8.7%, and it was more common in boys than girls. WHO provided the highest sensitivity: 95% of individuals with central obesity were classified with overweight or obesity. Using FIN provided the highest specificity (93%).

CONCLUSION

Our findings show that WHO overestimates the prevalence of overweight and obesity, while IOTF overrates thinness. Thus, comparing prevalence rates between studies requires caution. The novelty of this study is the comparison of the cutoff values for overweight with central obesity. The choice of reference system affects the generalizability of the research results.

Ascending Growth is Associated with Offspring Adiposity in Pregnancies Complicated with Obesity or Gestational Diabetes

CONTEXT

Early growth is associated with childhood adiposity, but the influence of lifestyle remains unknown.

OBJECTIVE

This work aimed to investigate the association of growth profiles from high-risk pregnancies with adiposity at age 5 years, taking into account lifestyle and several antenatal/postnatal exposures.

METHODS

This prospective cohort study.

INCLUDED

609 children born during the Finnish Gestational Diabetes Prevention Study (RADIEL), recruiting women with body mass index (BMI) greater than or equal to 30 and/or prior gestational diabetes mellitus (GDM) (2008-2013). Altogether 332 children attended the 5-year follow-up (2014-2017). Main outcome measures included growth profiles based on ponderal index (PI = weight/height3), investigated using latent class mixed models. Adiposity was assessed with anthropometrics and body composition (InBody720).

RESULTS

We identified 3 growth profiles: ascending (n = 82), intermediate (n = 351), and descending (n = 149). Children with ascending growth had a higher body fat percentage, ISO-BMI, and waist circumference (P < .05) at age 5 years. Ascending (β 4.09; CI, 1.60-6.58) and intermediate (β 2.27; CI, 0.50-4.03) profiles were associated with higher fat percentage, even after adjustment for age, sex, gestational age, diet, physical activity, education, and prepregnancy BMI. Similar associations existed with ISO-BMI. After adjusting for age and education, ascending growth was associated with prepregnancy BMI (odds ratio [OR] 1.06; CI, 1.01-1.12), primiparity (OR 3.07; CI, 1.68-5.62), cesarean delivery (OR 2.23; CI, 1.18-4.21), and lifestyle intervention (OR 2.56; CI, 1.44-4.57). However, meeting the intervention goals and exclusive breastfeeding for 3 months or more were associated with lower odds of ascending growth.

CONCLUSION

Accelerated early growth was associated with higher adiposity in 5-year-old children from high-risk pregnancies, even when adjusted for lifestyle. Reducing cesarean deliveries and promoting breastfeeding may be beneficial for postnatal growth.

Temperament, physical activity and sedentary time in preschoolers - the DAGIS study

Background

Identifying individual characteristics linked with physical activity (PA) and sedentary time (SED) can assist in designing health-enhancing interventions for children. We examined cross-sectional associations of temperament characteristics with 1) PA and SED and 2) meeting the PA recommendation in Finnish children.

Methods

Altogether, 697 children (age: 4.7 ± 0.9 years, 51.6% boys) within the Increased Health and Wellbeing in Preschools (DAGIS) study were included. Parents responded to the Very Short Form of the Children’s Behavior Questionnaire consisting of three temperament dimensions: surgency, negative affectivity, and effortful control. PA and SED were assessed for 7 days (24 h per day) using a hip-worn ActiGraph accelerometer, and the daily minutes spent in light PA (LPA), moderate PA (MPA), vigorous PA (VPA), and SED were calculated. The PA recommendation was defined as having PA at least 180 min/day, of which at least 60 min/day was in moderate-to-vigorous PA. Adjusted linear and logistic regression analyses were applied.

Results

Surgency was associated with LPA (B = 3.80, p = 0.004), MPA (B = 4.87, p < 0.001), VPA (B = 2.91, p < 0.001), SED (B = − 11.45, p < 0.001), and higher odds of meeting the PA recommendation (OR = 1.56, p < 0.001). Effortful control was associated with MPA (B = − 3.63, p < 0.001), VPA (B = − 2.50, p < 0.001), SED (B = 8.66, p < 0.001), and lower odds of meeting the PA recommendation (OR = 0.61, p = 0.004). Negative affectivity was not associated with PA, SED, or meeting the PA recommendation.

Conclusion

Children’s temperament should be considered when promoting PA in preschoolers. Special attention should be paid to children scoring high in the temperament dimension effortful control.

High abundance of sugar metabolisers in saliva of children with caries

Dental caries is a biofilm-mediated, dynamic disease with early onset. A balanced salivary microbiota is a foundation of oral health, while dysbiosis causes tooth decay. We compared the saliva microbiota profiles in children with and without caries. The study consisted of 617 children aged 9–12 years from the Finnish Health in Teens (Fin-HIT) study with available register data on oral health. Caries status was summarised based on Decayed, Missing, and Filled Teeth (DMFT) index in permanent dentition. The children were then classified into the following two groups: DMFT value ≥ 1 was considered as cavitated caries lesions (hereafter called ‘caries’) (n = 208) and DMFT = 0 as ‘cavity free’ (n = 409). Bacterial 16S rRNA gene (V3–V4 regions) was amplified using PCR and sequenced by Illumina HiSeq. The mean age (SD) of the children was 11.7 (0.4) years and 56% were girls. The children had relatively good dental health with mean DMFT of 0.86 (1.97). Since sex was the key determinant of microbiota composition (p = 0.014), we focused on sex-stratified analysis. Alpha diversity indexes did not differ between caries and cavity free groups in either sexes (Shannon: p = 0.40 and 0.58; Inverse Simpson: p = 0.51 and 0.60, in boys and girls, respectively); neither did the composition differ between the groups (p = 0.070 for boys and p = 0.230 for girls). At the genus level, Paludibacter and Labrenzia had higher abundances in the caries group compared to cavity free group in both sexes (p < 0.001). Taken together, there were minor differences in saliva microbiota between children with and without caries. Potential biomarkers of caries were the sugar metabolisers Paludibacter and Labrenzia. These bacteria presumably enhance salivary acidification, which contributes to progression of dental caries. The clinical relevance of our findings warrants further studies.

Lifestyle and glycemic health 5 years postpartum in obese and non-obese high diabetes risk women

AIM

Women with prior gestational diabetes (GDM) are at increased diabetes risk. This study aimed to assess whether lifestyle is associated with glycemic health of high-risk women 5 years postpartum, taking into account the pre-pregnancy BMI.

METHODS

The RADIEL study enrolled before or in early pregnancy 720 women with pre-pregnancy BMI ≥ 30 kg/m² and/or prior GDM. The follow-up visit 5 years postpartum included questionnaires and measurements of anthropometrics, blood pressure, and physical activity (PA) as well as analyses of glucose metabolism, lipids, and inflammatory markers. We measured body composition (Inbody) and calculated a Healthy Food Intake Index (HFII) from Food Frequency Questionnaires (FFQ). ArmBand measured PA, sedentary time, and sleep. To take into account the diverse risk groups of GDM, we divided the women based on pre-pregnancy BMI over/under 30 kg/m².

RESULTS

Altogether 348 women attended the follow-up. The obese and non-obese women showed similar prevalence of glycemic abnormalities, 13% and 19% (p = 0.139). PA levels were higher among the non-obese women (p < 0.05), except for step count, and their HFII was higher compared to the obese women (p = 0.033). After adjusting for age, education, and GDM history, PA and HFII were associated with glycemic health only among obese women. When both lifestyle factors were in the same model, only PA remained significant. PA associated with other markers of metabolic health also among the non-obese women, excluding HbA1c.

CONCLUSION

Lifestyle 5 years postpartum was associated with better glycemic health only among the obese high-risk women. PA, however, is essential for the metabolic health of all high-risk women.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, http://www.clinicaltrials.com , NCT01698385.

Heavy Screen Use on Weekends in Childhood Predicts Increased Body Mass Index in Adolescence: A Three-Year Follow-Up Study

PURPOSE

We aimed to examine whether sedentary screen time changes when transitioning from childhood to adolescence and whether children's screen time, separately for school days and weekends, affects body mass index (BMI) in adolescents.

METHODS

This prospective 3-year follow-up study included 5,084 children with a mean (standard deviation) age of 11 (1) years at baseline and 14 (1) years at follow-up. Children reported screen time, more specifically, time spent viewing TV programs and using a computer outside school while sitting. We categorized children into light, medium, and heavy TV viewers and computer users separately for school days and weekends. We also calculated the age- and gender-specific BMI z-score (BMIz).

RESULTS

Time spent viewing TV changed from baseline to follow-up on school days and on weekends (p < .001 for both); the proportion of heavy TV viewers on school days (≥3 h/d) increased from 16% to 23% and on weekends (≥4 h/d) from 19% to 30%. Heavy TV viewers and computer users on both school days and on weekends had a higher BMIz 3 years later (p < .001 for all). After adjusting for age, gender, language, baseline BMIz, sleep duration, eating habits, exercise, and the other screen-time variables, heavy TV viewing on weekends remained significantly associated with an increased BMIz at follow-up (B = .078; p = .013).

CONCLUSIONS

The proportion of heavy screen users increases when transitioning from childhood to adolescence. Moreover, heavy screen use, especially on weekends in 11-year-old children, is associated with an increased BMI 3 years later.

A randomized lifestyle intervention preventing gestational diabetes: effects on self-rated health from pregnancy to postpartum

INTRODUCTION

The purpose was to examine the effects of a randomized lifestyle intervention on self-rated health from pregnancy to postpartum in participants at high risk for gestational diabetes mellitus.

METHODS

We included 266 women with a history of gestational diabetes and/or prepregnancy BMI ≥30 kg/m². The intervention group (n = 144) received individualized counseling on diet, physical activity, and weight management from trained nurses at six timepoints between the first trimester of pregnancy and 12 months postpartum, and met three times with a dietitian. The control group (n = 122) received standard antenatal care. We assessed self-rated health at the six timepoints by means of a single question with five response options ranging from good (1) to poor (5). Baseline-adjusted mean changes in self-rated health level were assessed with a mixed model for repeated measure methods.

RESULTS

The mean (SD) for self-rated health at baseline was 1.8 (0.8) in the intervention group and 2.1 (0.9) in the control group (p = 0.006). Self-rated health varied over time (time effect p < 0.001) and was the poorest in the third trimester. The sample indicated that self-rated health improved in the intervention group and deteriorated in the control group from the first trimester to 12 months postpartum, but the difference between the groups did not reach statistical significance (group effect p = 0.064).

DISCUSSION

The self-rated health level varied over time from the first trimester of pregnancy to 12 months postpartum in women at risk for gestational diabetes. Improving self-rated health among high-risk pregnant women through lifestyle intervention calls for further research.

Cardiorespiratory fitness and health-related quality of life in women at risk for gestational diabetes

This study examined the associations of cardiorespiratory fitness (CRF) and leisure-time physical activity (LTPA) with health-related quality of life (HRQoL) in women at risk for gestational diabetes mellitus (GDM). The participants were 39 women planning pregnancy with a history of GDM and/or BMI >29 kg/m² . We assessed CRF by measuring maximal oxygen consumption (VO_2max ) during incremental cycle ergometer exercise until voluntary fatigue. LTPA was self-reported, and HRQoL assessed with the SF-36 Health Survey (SF-36). The mean (SD) VO_2max was 27 (6) mL·kg^-1 ·min^-1 , and the mean LTPA was 2.6 (1.7) h/wk. After controlling for BMI, VO_2max was positively associated with the SF-36 General Health scale (β 1.27, 95% CI: 0.09, 2.44, P=.035) and the Physical Component Summary (β 0.48, 95% CI: 0.14, 0.82, P=.007). The General Health scale (P=.023) and the Physical Component Summary (P=.011) differed even between those with very poor and poor CRF. After controlling for BMI, LTPA was positively associated with the SF-36 Physical Functioning scale (r_s =.34, P=.039), the General Health scale (β 3.74, 95% CI: 0.64, 6.84, P=.020), and the Physical Component Summary (β 1.13 95% CI: 0.19, 2.06, P=.020). To conclude, CRF and LTPA were positively associated with perceived general health and physical well-being in women planning pregnancy and at risk for GDM. Even a slightly better CRF would be beneficial for well-being among women with low levels of CRF.

The effects of health counseling and exercise training on self-rated health and well-being in middle-aged men: a randomized trial

BACKGROUND

Few community-based lifestyle interventions have examined subjective well-being. We examined the effects of health counseling and exercise training on self-rated health (SRH), self-rated well-being (SRW) and depressive symptoms in middle-aged men at increased risk for cardiovascular disease (CVD) in a randomized controlled trial.

METHODS

Men (N.=168) with at least two CVD risk factors engaging in leisure-time physical activity less than three times/week were randomized into: A) a group receiving single-session health counseling; B) a group receiving single-session health counseling and three months of weekly structured group exercise training; or C) a control group. We assessed SRH and SRW using visual analogue scales and depressive symptoms using a brief depression screener (the Patient Health Questionnaire-2, PHQ-2).

RESULTS

Generalized estimating equation (GEE) models showed that, after 3 and 12 months, SRH (P=0.024) and SRW (P=0.014) improved across all groups. We found no differences between the groups (group by time effect, P=0.44 and P=0.80). The proportion of men with PHQ-2 scores ≥3 (positive depression screen) decreased in groups A (from 27% to 13%) and B (from 34% to 18%), but increased among controls (from 26% to 31%) (group by time effect, P=0.078).

CONCLUSIONS

We found improvements in SRH and SRW, with a diminishing proportion of men screening positive for depression one year after a single health counseling session and a three-month exercise-training program. We detected, however, no statistically significant differences when comparing men who received health counseling or health counseling combined with exercise training to controls.

Associations of physical activity with self-rated health and well-being in middle-aged Finnish men

Aims: We examined the associations of physical activity (PA) frequency with self-rated health (SRH), self-rated well-being (SRW) and depressive symptoms, in middle-aged men in Finland. Methods: The cross-sectional study comprised 665 men (mean age 41 ± 3 SD years; body mass index (BMI) 26.8 ± 4.2 SD kg/m2), who had completed the screening questionnaire of an intervention for men with cardiovascular risk factors. Their weekly frequency of PA was assessed by a questionnaire, SRH and SRW by visual analog scales (VAS), and depressive symptoms by the Patient Health Questionnaire-2 (PHQ-2). Results: The mean SRH ± SD (range of scale 0–100) by PA frequency categories was 56.2 ± 18.5 for PA sometimes or never, 63.8 ± 16.2 for PA about 1–2 times/week, and 71.1 ± 15.5 for PA at least 3 times/week. The mean SRW ± SD (range of scale 0–100) was 59.0 ± 20.4, 65.6 ± 17.6, and 68.9 ± 17.1, respectively. The mean PHQ-2 score ± SD (range of scale 0–6) by PA categories was 1.83 ± 1.40 for PA sometimes or never, 1.68 ± 1.28 for PA about 1–2 times/week, and 1.60 ± 1.31 for the PA at least 3 times/week group. SRH and SRW improved linearly with increasing PA frequency (both p < 0.001), and the results remained similar after adjustment for BMI, education and smoking status. No association existed between PA frequency and PHQ-2. Conclusions: More frequent PA was linearly associated with better SRH and SRW, but not with depressive symptoms that were measured by a brief depression screening tool.

Exercise intervention and health checks for middle-aged men with elevated cardiovascular risk: a randomized controlled trial

OBJECTIVE

To study the effects of a health check by a nurse alone or combined with an exercise intervention in middle-aged men at increased cardiovascular risk.

DESIGN

A randomized controlled trial.

SETTING AND INTERVENTION

Primary care in Kirkkonummi municipality with 36 000 inhabitants. A health check by a nurse alone or combined with an exercise intervention to controls with no intervention was compared.

SUBJECTS

A total of 168 men aged 35 to 45 years with at least two cardiovascular risk factors and physical activity (PA) frequency < 3 times a week.

MAIN OUTCOME MEASURES

Metabolic syndrome (MetS) as defined by International Diabetes Federation/American Heart Association and self-reported PA frequency.

RESULTS

Overall, focusing on health increased physical activity frequency in middle-aged men. After one year, 19% had increased PA to ≥ 3 times a week (95% CI 12-26). All study groups increased PA to ≥ 3 times: 26% of men in the exercise intervention group, 15% of men in the health check group, and 16% of controls. The differences between the groups were not statistically significant. The intervention did not have any meaningful impact on MetS or other cardiovascular outcomes at one-year follow up.

CONCLUSIONS

Physical activity increased in all study groups of middle-aged men in this health-promotion trial. The interventions had no effect on metabolic syndrome or other cardiovascular outcomes in the participants. The trial increased awareness and collaboration in physical activity promotion among municipal health care and exercise services.

Life events and change in leisure time physical activity: a systematic review

The global epidemic of chronic non-communicable diseases is closely related to changes in lifestyle, including decreasing leisure time physical activity (PA). Physical inactivity is a major public health challenge. To respond to that challenge, it is essential to know which personal and environmental factors affect PA behaviour. Certain life events may be one contributing factor, by creating emotional distress and disrupting a person's daily routine. The aim was to examine the literature concerning the effects of life events on changes in PA. A systematic literature search was performed on studies that assessed at least one major change in life circumstances and a change in PA. To be included, studies had to assess PA at two timepoints at least (before and after the event). Diseases as life events were excluded from this review. Thirty-four articles met the inclusion criteria. The studies examined the following life-change events: transition to university; change in employment status; marital transitions and changes in relationships; pregnancy/having a child; experiencing harassment at work, violence or disaster; and moving into an institution. The studies reviewed showed statistically significant changes in leisure PA associated with certain life events. In men and women, transition to university, having a child, remarriage and mass urban disaster decreased PA levels, while retirement increased PA. In young women, beginning work, changing work conditions, changing from being single to cohabiting, getting married, pregnancy, divorce/separation and reduced income decreased PA. In contrast, starting a new personal relationship, returning to study and harassment at work increased PA. In middle-aged women, changing work conditions, reduced income, personal achievement and death of a spouse/partner increased PA, while experiencing violence and a family member being arrested or jailed decreased PA. In older women, moving into an institution and interpersonal loss decreased PA, while longer-term widowhood increased PA. In addition, experiencing multiple simultaneous life events decreased PA in men and women. Major life events have a strong effect on leisure PA behaviour. Consequently, people experiencing life events could be an important target group for PA promotion. More research is needed to examine the short- and long-term effects of different life events on PA, gender differences in the effects of life events and the specific determinants of PA change during life events.

Identification of calmodulin-binding proteins on membranes of secretory granules isolated from bovine neurohypophyses

Membrane proteins from isolated, purified ox neurohypophyseal secretory granules were separated by sodium dodecylsulphate (SDS) polyacrylamide gel electrophoresis (PAGE). Using a gel overlay technique, after renaturation procedures, it was demonstrated that 125J calmodulin bound in a Ca2+-dependent way to two protein bands with molecular weights (MW) of 58,000 and 52,000. Binding of small amounts of calmodulin to other protein bands was independent of calcium. No calmodulin binding to granule content proteins could be detected. Treatment of the granules with trypsin prior to separation of membrane proteins removed the Ca2+-dependent binding proteins from the granule membrane. On incubation of granules with [gamma-32P]ATP, protein bands with MW of 52,000 and 45,000 showed a marked phosphorylation activity. The 52,000 band had the same electrophoretic mobility as one of the calmodulin-binding bands. However, no effect of calmodulin on phosphorylation of this band could be demonstrated.